Friends,
I did not hear back from the person who said they had an  article discussing
a study of breastmilk volume when Depo is given prior to the milk coming in.
Anyone aware of this?  I recently raised my concern to a first year resident,
that the manufacturer recommends waiting until the supply is established, and
she flipped out. She wouldn't listen. Her take was "innocent until proven
guilty" when I asked if she had studies to say it was safe to use.  And her
mom btw, exclusively breastfed and had her 2 sisters 11 months apart...blah,
blah, blah. .. It is true that only about 3% of our clinic patients return
for their 6 week check up, but i have to wonder how many come back for their
3 month shot. I also know that this segment of our population often intends
to supplement by 1 month. When i tried to dialogue about riskbenefit ratio,
she cut me off and brought up her mom again. It was extremely frustrating. I
asked for a compromise, which was that the order not be written until the day
of discharge, which she agreed to reluctantly but has since retracted. Today
she told me that several patients had refused their depo and she took the
issue up with our medical director and he was livid. Actually they were just
wanting to delay it.  I have no doubt that i was totally misrepresented
there, but since he is our new ob director I don't have the history of trust
so next week when he is back in town I'll probably set an appt to be
proactive and not wait to just see him in the halls or be called in. .  All
this to say - any data out there?  In the absence of data, do i have a leg to
stand on that the manufacturer recommends waiting?  This also reeks of the
great white doctor god trying to control the reproductive life of her poor,
irresponsible patients...and it makes me sick.
thanks for listening.
chris

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